25 lakh+
Iziguli Ezijabule
Abanolwazi futhi
odokotela abanekhono
17
Izikhungo Zokunakekela Ezempilo
Isikhungo Sokudluliswa Okuphezulu kakhulu
Ngokuhlinzwa Okuyinkimbinkimbi
I-carotid stenting idlala indima ebalulekile ekwehliseni ingozi yokushaywa unhlangothi ezigulini ezine-carotid artery stenosis. Lokhu kwelashwa okungangeneleli kancane kuma njengendlela esebenzayo eceleni kwe-carotid endarterectomy (CEA) yeziguli ezithile. Ukwelashwa kusebenza kahle kakhulu kulabo abane-asymptomatic yezinga eliphezulu (ngaphezu kwama-70%) noma i-carotid artery stenosis eyizimpawu.
I-Stenting ifakazela ukuthi kunenzuzo kakhulu kune-endarterectomy ezigulini ezinesifo senhliziyo esibi kakhulu, ukwehluleka kwenhliziyo, isifo samaphaphu esinzima, noma izici ezithile ze-anatomic ezifana nokuvala i-carotid contralateral. Ikusasa libukeka lithembisa njengentuthuko yezobuchwepheshe, okuhlanganisa amathuluzi athuthukisiwe okuvikela i-embolic nama-stents anezendlalelo ezimbili, akhomba emiphumeleni engcono yesiguli.
CARE Izibhedlela inelinye lamaqembu amakhulu e-India emithambo yegazi anesipiliyoni seminyaka engu-20+. Iqembu linabayisishiyagalombili odokotela abahlinza imithambo yegazi kanye nama-radiologist amahlanu angenelelayo asebenza ndawonye ngaphansi kophahla olulodwa. Laba ngcweti bathole ulwazi oluyingqayizivele ngokuqeqeshwa kwabo e-India, Japan, UK nase-USA. Iqembu le-vascular lithola ukwesekwa okuthembekile kusuka ku-multi-speciality, i-anesthesia, kanye namathimba okunakekela okubucayi aqinisekisa imiphumela emihle kakhulu yesiguli ngayo yonke inqubo.
Odokotela Abahlinza Karotid Abangcono Kakhulu eNdiya
Isibhedlela i-CARE sihola phambili ekuthuthukisweni kobuchwepheshe be-carotid stenting. Isibhedlela sihlole ukuthi kungenzeka yini ukuqina kwe-carotid esizwa ngerobhothi ngokuhlolwa komtholampilo kwe-'CARE'. Izinqubo eziyisikhombisa zerobhothi zenziwa kusetshenziswa inkundla yerobhothi ethuthukisiwe ethuthukayo ukwelashwa kwenhliziyo nemithambo yegazi ngokuthuthukisa ukunemba kodokotela kanye nokunciphisa kakhulu ukuchayeka kwe-X-ray kwabasebenzi bezokwelapha. Izinqubo zithole izinga eliphezulu lempumelelo yomtholampilo.
I-CARE Hospital's carotid stenting yelapha isifo se-carotid artery-isimo lapho ulwelwesi lwemithambo ye-carotid yangaphakathi luncipha ukusuka. cholesterol noma i-triglyceride deposits. Le nqubo yokuncipha (i-atherosclerosis) ikhawulela ukugeleza kwegazi ebuchosheni futhi ingabangela imivimbo. Inqubo isiza iziguli ezine-carotid stenosis ebaluleke kakhulu, ikakhulukazi lezo ezingakwazi ukwenza i-endarterectomy yendabuko ngenxa yezinkinga zezokwelapha ezifana nesifo senhliziyo esinzima, samaphaphu, noma sezinso.
Isibhedlela se-CARE sihlinzeka ngezinhlobo ezahlukene ze-stent ngokusekelwe ezidingweni zesiguli:
Ithimba lezokwelapha likhetha uhlobo ngalunye lwe-stent ngokusekelwe esimweni esithile sesiguli, ukwakheka kwama-plaque nokucatshangelwa kwe-anatomical.
Iziguli kudingeka zilungise imithi yazo, ikakhulukazi uma zinemithi enciphisa igazi, ngaphambi kwenqubo. Udokotela wakho uyala ukuhlolwa okuningana okubalulekile okuhlanganisa i-ECG, ukuhlolwa kwegazi, ne-carotid imaging. Ithimba lezokwelapha linikeza isiqondiso esithile mayelana:
Ukuhlinzwa kuthatha phakathi kwemizuzu engama-30 kuya emahoreni ama-2. Ithimba lezokwelapha liqala nge-anesthesia yendawo kanye ne-sedation. Bafaka i-catheter endaweni encane ye-groin. Khona-ke udokotela ohlinzayo:
Ukuhlala esibhedlela kuvame ukuthatha amahora angama-24-48. Ithimba lezokwelapha libheka ngokucophelela izimpawu ze-stroke noma ukopha ngemva kokuhlinzwa. Iziguli zidinga izinsuku ezimbalwa kuya evikini lokuzivivinya okulinganiselwe.
Izinkinga ezinkulu zingabandakanya:
Le nqubo inikeza izinzuzo ezimbalwa ngaphezu kokuhlinzwa kwendabuko:
I-Medicare inikeza ukuhlinzekwa kweziguli ezinezimpawu ze-stenosis ezibhekene nezingozi eziphezulu nge-carotid endarterectomy. Thola ulwazi olugcwele kumhlinzeki wakho womshwalense ngaphambi kokwelashwa.
Umbono wesibili wezokwelapha ubonakala ubalulekile uma uthola:
I-carotid stenting iyindlela enhle yokuthola ukwelashwa kweziguli ezine-carotid artery stenosis. Le nqubo engangeneleli kancane isebenza njengenye indlela esebenzayo yokususa i-endarterectomy yendabuko, ikakhulukazi uma unezimo zenhliziyo ezinzima, isifo samaphaphu noma izici ezithile ze-anatomical. Iphrofayela yakho yezempilo ngayinye inquma ukukhetha okungcono kakhulu kokwelashwa.
Ithimba le-CARE Hospitals Group lodokotela abahlinza imithambo yegazi kanye nama-radiologist angenele liletha imiphumela emihle kakhulu. Ukuzibandakanya kwabo ezivivinyweni zomtholampilo ezithuthukisiwe, okuhlanganisa i-robotic carotid stenting, kubonisa ukuzinikela kwabo okuqinile ekunakekelweni kwesiguli. Izinga eliphezulu lempumelelo emtholampilo phakathi nalezi zivivinyo libonisa ubuchwepheshe balo.
Izibhedlela Ezingcono Kakhulu Zokuhlinzwa Kwe-Carotid eNdiya
I-carotid stenting ivula imithambo ye-carotid evalekile enokuhlasela okuncane. Inqubo ibeka ishubhu elincane elinenetha (stent) engxenyeni ewumngcingo yomthambo wakho we-carotid othuthukisa ukugeleza kwegazi ebuchosheni bakho. Udokotela wakho ohlinzayo wenza ukusikeka okuncane ku-groin yakho ukuze afake i-catheter, ayiqondise entanyeni yakho, futhi amise i-stent ukuze ugcine umthambo uvulekile. I-stent isebenza njengohlaka olugcina umthambo wakho usesimweni esinempilo.
Amaqembu ezokwelapha ngokuvamile ancoma le nqubo:
Amakhandidethi ahamba phambili afaka iziguli ezine:
I-carotid stenting ifakazele ukuthi iphephile futhi isebenza ngempumelelo. Kokubili i-stenting kanye ne-endarterectomy kunciphisa ingozi yokushaywa unhlangothi kakhulu eminyakeni eyishumi ngemva kokwelashwa.
Inqubo ngokuvamile ithatha imizuzu engu-30 ukuqeda. Ezinye izimo zingadinga amahora afinyelela kwamabili ngokuya ngobunkimbinkimbi bemikhumbi kanye ne-anatomy. Ukuhlinzwa akuvamile ukuthatha isikhathi eside ngaphandle uma kuvela izinselele ezingalindelekile.
Izinkinga ezijwayelekile zihlanganisa:
I-carotid stenting ayihli ngaphansi kokuhlinzwa okukhulu. Odokotela bakuhlukanisa njengokungahlinzeki, inqubo ehlasela kancane. Inqubo idinga ukusika okuncane, futhi iziguli zivame ukuphuma esibhedlela phakathi namahora angu-24-48. Ukululama kuthatha cishe isonto, okungasondeli nakancane nesikhathi esidingekayo sokuhlinzwa kwe-carotid yendabuko.
Iziguli zihlala esibhedlela amahora angama-24-48 ngesikhathi senqubo yokuqapha. Inqubo yokutakula iyaqhubeka ekhaya futhi ithatha cishe amasonto angu-1-2. Imisebenzi evamile ingaphinda iqale ngemva kosuku noma ezimbili, kodwa iziguli kufanele zigweme imisebenzi ekhandlayo izinsuku ezingu-5-7 kuze kube yilapho indawo yokusika ilulama ngokugcwele.
Ingozi yokushaywa unhlangothi ngemva kwe-carotid stenting ihlala iphansi kakhulu. Ama-stents ayaqhubeka nokukhula ngemva kokubekwa futhi akhiqize ukukhula kwezicubu okudala ibhalansi, okusiza ukugcina ukugeleza kwegazi okufanele.
Odokotela benza i-carotid stenting ngaphansi kwe-anesthesia yendawo nge-sedation encane. Le ndlela ibasiza ukuthi baqaphe izimpendulo zemizwa kuyo yonke inqubo.
Lezi ziqondiso zizosiza ukuqinisekisa ukuphulukiswa okufanele:
Ama-carotid stents ahlala unomphela emthanjeni wakho. Ukunciphisa kabusha kwenzeka ngenani elincane lamacala, ngokuvamile phakathi nezinyanga ezingu-6-9 ngemva kwenqubo.
Ama-Mini-stroke noma ama-TIA ngokuvamile asebenza njengophawu lokuqala oluyisixwayiso. Iziguli zingase zizwe ukukhathala, imithambo yentamo eqhumayo, ukuba ndikindiki, ubuhlungu besifuba, isiyezi, ukulingana okungalungile, izindlebe ezikhalayo, kanye umbono ongenalutho.
Izinkinga zokubona, ukudideka, izinkinga zenkumbulo, ubuthakathaka ohlangothini olulodwa lomzimba wakho, nobunzima bokucabanga nokukhuluma kuyizimpawu ezivamile zokuxwayisa. Odokotela bangathola umsindo ongajwayelekile obizwa ngokuthi "i-bruit" lapho belalele imithambo yakho ye-carotid.